LSWA-WIOA Young Adult Interest Survey

WIOA Young Adult Interest Survey

Scholarships are awarded based on eligibility determination, suitability criteria and the availability of training funds. Submitting an application does not mean you are going to be selected for this program, Submitting an application is only the first step in your WIOA application process. IMPORTANT REMINDER: Please make sure to read each question carefully. Each question should be answered completely. Applications that are submitted with missing or invalid information will be considered incomplete and will not be reviewed. If you would like to check on the status of your application please contact 410-341-6440
Name

First NameLast Name
Birthdate

MonthDayYear
2 digit month, 2 digit day, 4 digit yearYou must be 16-24 years old to qualify for the Young Adult Program
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Second Contact Phone Number
Please enter a valid secondary phone number.Format: (000) 000-0000.
Email
example@example.com
Preferred Method of Contact:
Marital Status
Do you have children?
How many dependents do you have under 18?
Do you have a High School Diploma or GED?
Are you currently enrolled in any school?
Are you registered for Selective Service?
The Selective Service System is an independent agency of the United States government that maintains a database of registered MALE U.S. citizens and other U.S. residents potentially subject to military conscription. In order to receive WIOA scholarships, you must be registered for Selective Service as the LSWA WIOA program is federally funded. To verify your Selective Service Status, visit www.sss.gov or call 1-847-688-6888 to request a status information letter. If you are not registered for Selective Service, and there are qualifying reasons as to why you are not, please email our counselors at training@tcclesmd.org for further information.
Are you a U.S. citizen or authorized to work in the U.S.?
Employment Status:
Please select all that apply to your current situation (Documentation for each selection will be required for enrollment):
What are your career, education, or employment goals?
What about this program interests you?
Drivers License

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Birth Certificate

Cancelof
Proof of Residency

*Lease, Utility Bill, Postage mail with name and address indicated*
Cancelof
Verification of Income

*ex. Paystub, W2, SSI/Award Letter, If you are unemployed please contact us at 410-341-6010*
Cancelof
Selective Service Documentation

*Males aged 18+, download proof of registration from www.sss.org and upload here. If you are not registered, please contact us at 410-341-6010*
Cancelof
Social Security Card

*Clear Photo or Scan Required for MWE Purposes*
Cancelof
How did you hear about us?
ex. Social media, Word of Mouth, Flyer
Please verify that you are human
Should be Empty: